Disposable light-conductive speculum

ABSTRACT

A THREE PIECE VAGINAL SPECULUM INCLUDING A FIXED BLADE WITH INTEGRAL DEPENDING HOLLOW HANDLE AND A FORKED SLIDE MEMBER CARRIED ON THE HANDLE. A PAWL INTEGRAL WITH THE SLIDE IS SELECTIVELY ENGAGEABLE WITH TEETH ON THE HANDLE. A MOVABLE BLADE IS PIVOTALLY CARRIED ON THE FORK ENDS OF THE SLIDE AND HAS AN INTEGRAL LEVER PROJECTING PROXIMALLY. AN INTEGRAL SLIDE TONGUE HAS TEETH SELECTIVELY ENGAGEABLE WITH AN ABUTMENT ON THE LEVER. THE THREE PARTS ARE MOLDED PLASTIC AND A PORTION OF THE FIXED BLADE IS ADAPTED TO CARRY LIGHT FROM A SOURCE IN THE HANDLE TOWARD THE BLADE ENDS.   D R A W I N G

Feb. 13, 1973 w. c. MOORE ET AL DISPOSABLE LIGHT-CONDUCTIVE SPECULUM 2Sheets-Sheet 1 Filed Dec. 21. 1970 INVEN TORS. WILLIAM C. MOORE,

WILLIAM s. PILGRIM. a y MELVIN RCALDWELL Feb. 13, 19 73 I w MOORE ETAL3,716,047

' DISPOSABLE LIGHT-CONDUCTIVE SPECULUM F1196. D60. 21, 1970 I 2Sheets-Sheet 2 w HH IN VE N TORS.

WILLIAM C. MOORE WILLIAM S. PILGRIM MELVIN R. CALDWELL 0 MA 5r UnitedStates Patent Ser. No. 99,967

Int. Cl. A61b 1/06 US. Cl. 128-18 1 Claim ABSTRACT OF THE DISCLOSURE Athree piece vaginal speculum including a fixed blade with integraldepending hollow handle and a forked slide member carried on the handle.A pawl integral with the slide is selectively engageable with teeth onthe handle. A movable blade is pivotally carried on the fork ends of theslide and has an integral lever projecting proximally. An integral slidetongue has teeth selectively engageable with an abutment on the lever.The three parts are molded plastic and a portion of the fixed blade isadapted to carry light from a source in the handle toward the bladeends.

CROSS-REFERENCE TO RELATED APPLICATION This application is acontinuation-in-part of application Ser. No. 718,472, filed Apr. 3,1968, now abandoned, by the same inventors under the same title.

BACKGROUND OF THE INVENTION This invention relates to medical diagnosticinstruments and more particularly to a vaginal speculum having pivotedand adjustable parts, including light conducting means, which are ofmolded plastic so as to be economically made and disposable after use.

This type of instrument has a pair of dilatory blades and means areprovided for varying both the spacing and angular relation of theblades. Specula of the prior art usually have adjustment means which aredifficult to manipulate and/ or lighting arrangements which do notadequately illuminate the body cavity being examined, the inadequatelighting being due to light losses and failure to make the lightingtruly directional. Furthermore, specula with the requisite adjustabilityhave usually been expensive to manufacture and ditficult to sterilize.

SUMMARY OF THE INVENTION The speculum of the invention comprises threepieces of molded non-toxic plastic material having high strength so thatit can be made at a cost low enough to warrant discarding after a singleuse. The two blade members are of a clear plastic havinglight-conducting properties, and a handle or leg portion is provided forholding the instrument without contaminating the sterilized blades. Thethird part is of a more resilient but strong plastic and is providedwith separate latching means for obtaining the desired spacing andangular adjustment of the blades. The latch means which permit theseadjustments are located adjacent the handle and adjacent one another ineasy reach of the thumb or a finger of the hand grasping the handle.

The handle or leg portion is hollow and is adapted to receive andreleasably hold a light source or light carrier which, in turn, has aprojecting end adapted to be releasably secured in a light source handlefor transmitting light to a curved plastic light bar integral with oneblade and its integral handle or leg. The light bar has an opticalsurface in the hollow of the handle or leg for receiving light from thesource and another optical surface spaced from the facing the distalends of the blades for emitting the light and directing it toward thearea of the body cavity being examined. The examining physician is ableto hold and manipulate the instrument with one hand leaving his otherhand free for obtaining a biopsy sample or performing any othernecessary operation.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a side elevational view ofthe speculum according to the invention shown in combination with alight source handle shown fragmentarily;

FIG. 2 is a sectional view of the blades on the line 22 of FIG. 1;

FIGS. 3 and 4 are plan and side elevational views, respectively, of theslide member shown in FIG. 1;

FIG. 5 is an enlarged sectional view on the line 55 of FIG. 1;

FIG. 6 is a proximal end view of the fixed blade member of FIG. 1;

FIG. 7 is a sectional view on the line 77 of FIG. 6;

FIGS. 8 and 9 are fragmentary side elevational and plan views of themovable blade member, respectively, the latter as viewed in thedirection of the arrows 99 of FIG. 1;

FIGS. 10 and 11 are side elevational views, rotated degrees one from theother, of the carrier member of FIG. 1.

DESCRIPTION OF THE PREFERRED EMBODIMENT Referring to FIG. 1, the vaginalspeculum 10 comprises the fixed blade member 11, the slide member 12,and the movable blade member 13.

The fixed blade member 11 has a conventionally curved and smoothlyrounded trough-shaped blade 14 and an integral depending handle 15,hereinafter referred to as leg to prevent confusion with the lightsource handle.

The trough shape of the blade 14 continues to its proximal end 16 wherethe trough deepens and its floor curves to open into the hollow leg 15.In this curve, a curved light bar portion 17 of substantially uniformrectangular cross sectional configuration is integrally molded so thatit projects from the floor of the trough. Alternatively, the curvedportion may be separately molded and secured in place.

The curved light bar 17, best seen in FIG. 6, has a lightreceivingoptical surface 18, best seen in FIG. 7, inside the hollow leg 15 facingthe end of the leg. At its other end, the light bar 17 has alight-emitting optical surface 19 that is substantially perepndicular tothe longitudinal axis of the fixed blade. The light emitting surface 19is the only surface where the light rays transmitted by the light barexceed the critical angle which allows the rays to be emitted. Moreover,the light rays emitted from the surface 19 are directional rather thanscattered, and substantially all of the light is directed towards thefield being examined adjacent the distal ends of the blades withouthaving scattered rays directed back into the eyes of the examiningphysician. In this connection, the substantially uniform cross sectionof the light bar is important because if the bar were tapered from itslight-receiving to its light-emitting end the light rays would exceedthe critical angle before reaching the light-emitting end and therewould be unwanted light losseses and scattered rays.

The location of the light bar emitting surface on the blade 14 is alsoimportant. As can be seen from FIG. 1, the light bar terminates so thatits light-emitting surface 19 is spaced from the distal ends of theblades by a distance that is approximately two-thirds of the length ofthe fixed blade. In normal usage, the extent of the penetration of theblades into the body cavity is a little less than this distance so thatthere is virtually no light loss due to body contact with the patient inthe area of the light bar.

Leg 15, below the light bar 17, has a U-shaped sidewall, the end of eacharm of the U having an inwardly projecting flange 20, best seen in FIG.5. The flanges 20 are spaced apart leaving a slot 21 in the proximalside of, and extending the length of, leg 15. As best seen in FIG. 6,the flanges continue in the same common plane along the proximal end 16of the fixed blade 11 where it is flared and faired to widen above theleg 15. Flanges 20 terminate short of but adjacent the top of the end 16in FIG. 6.

The slide member 12, which is made of a tough but resilient plasticmaterial such as polypropylene or nylon, has a forked upper end 2222 andconforms generally to the shape of the slot 21 and its widened portionat the proximal end 16 of the fixed blade. Each side of the slide 12 isgroowed at 23, the grooves 23 extending up the outer sides of the forkedarms 22 in coplanar fashion to a point just short of the ends of arms 22where the arms have coaxially disposed journal holes 24.

The grooves 23 are dimensioned to receive the flanges 20 of leg 15 and,when the slide 12 is in its unextended position, as shown in FIG. 1, thegrooves 23 along arms 22 receive the flanges along the widened proximalend 16 of fixed blade member 11.

The unforked end of the slide member 12 has a pawlshaped lever or pawl25 connected at its center to the slide by a relatively thin bridgingportion 26 of plastic material so that the lever or pawl 25 can betilted by flexing the bridging portion 26. The pointed nose 27 of thepawl 25 is biased toward and engageable with ratchetshaped teeth 28 onthe proximal face of the leg 15 so that when the slide 12 is movedupward in FIG. 1 with respect to leg 15 its return downward is preventedby the engagement of the nose 27 with the teeth 28 until released bypushing against the other finger piece end 25' of pawl 25.

The slide member 12 also has an integral proximally projecting,comparatively thin tongue 30 which is curved about a center lying on thecommon axis 31, shown in FIG. 3, of the journal holes 24 in arms 22 ofthe slide. Tongue 30 has ratchet teeth 32 thereon.

The movable blade member 13 and fixed blade member 11 are of atransparent, strong, and comparatively inflexible plastic material suchas acrylic or styrene plastic. While this plastic material istransparent, members seen through the plastic are shown in broken linesin the drawings to prevent confusion.

Movable blade member 13 has an inverted-trough shaped blade 33 ofconventional smoothly curved and rounded shape. At the proximal end ofblade 33 the member 13 has an outwardly projecting pin 34 on each sidewhich pins are engaged in the holes 24 of slide arms 22 by spreading thearms apart, the resiliency of the material of slide 12 retaining thepivot pins 34 engaged in the journal holes.

A lever portion 35 projects proximally at an obtuse angle from theproximal end 36 of blade 33. The lever portion 35, best seen in FIG. 9,comprises two arms 37 projecting from the sides of the open end 36 ofthe blade and defining a proximal throat opening 38 in the lever 35 foraccess to the instrument throat formed by the oppositely faced troughshape of the blades. At the end of the throat opening 38 arms 37 arejoined by a yoke portion 39 which has a pawl-like bevelled edge orabutment indicated at 40 in FIGS. 8 and 9. A pendant thumb or fingerpiece 4 is provided on the yoke portion 39, and arms 37 have outwardlyprojecting stiffening flanges 42 as shown in FIG. 8.

The bevelled edge 40 is located so as to be engaged in one or another ofthe ratchet teeth 32 by the bias of the tongue 30 as the acute anglewhich lever 35 normally makes with the leg 15 is reduced. Adjusting theangle between the lever portion 35 and leg portion 15, with its attachedslide member 12, adjusts the angular relation of blade 33 with respectto blade 14 and hence the spacing of the distal ends of the blades.

Referring again to FIG. 1 a non-disposable member,

the light carrier 45, is shaped to fit within the hollow of leg portion15 adjacent the slide 12 as best ssen in FIG. 5. The carrier 45 isdimensioned to have one end 46 project beyond the end of leg 15 and thisend 46 is square in cross section with a detent groove 47 therearound atapproximately the midpoint of the projecting end. The square end 46 isadapted to fit in the conforming socket of a conventional light-sourcehandle fragmentarily shown at 50 in FIG. 1. The handle socket has one ormore spring pressed ball detents, not shown, to engage the detent goove47.

Carrier 45 has a sidewall 51 surrounding a bundle of glass fibers 52 forcarrying light from the source at the end 46 to the end 53 adjacent theface 18 of lght bar 17, and has a pin 54 releasably engageable in hole55 in the leg portion.

Alternatively, of course, a special light handle, with one end shapedlike the carrier 45, may be provided, the light source being disposed inthe end thereof for illuminating the surface 18.

In operation, the three piece speculum 10 is supplied in a clean sealedpackage. The physician unwraps the instrument, being careful to grasponly the leg portion 15. He then inserts his light source handle or thecarrier 45 thereof in the hollow of the leg. The light handle now isreleasably secured to leg 15 of the speculum and the speculum may bemanipulated by grasping leg portion 15.

It will be noted that in FIG. 1, blades 14 and 33 are not completelyclosed because the abutment edge 40 of the lever 35 is not engaged inthe outermost tooth 32 of tongue 30. It will be understood that thespeculum 10 would normally be completely closed at this time, thenarrower distal end of the shorter blade 33 being depressed inside thetrough of fixed blade 14.

The blades of speculum 10 are now inserted in the usual manner in thebody cavity to be examined and the light source illuminated. With athumb or finger of the hand grasping the instrument, the physician movesthe slide 12 along leg 15 by pressure against the pointed end portion ofthe pawl 25 to separate the proximal ends of the blades. When the labialportion of the cavity is sufficiently dilated, the pressure on pawl 25is ended and the point 27 of the pawl stays engaged with one of theratchet teeth 28 of the leg and remains biased in engagement therewithby the resiliency of bridging portion 26, latching the slide in relationto the fixed blade member 11.

With the thumb or a finger of the hand grasping the instrument, thephysician now depresses the lever 35 by pressure on the finger piece 41thereby rotating the movable blade member 13 on its pivot pins 34 andchanging the angular relation of the blades. As the distal ends of theblades separate, the vaginal walls are distended so as to unfold forexamination. The tongue 30 is biased by its resiliency against thebevelled edge 40 so that the ratchet teeth 32 are successively engagedby the edge 40 as the distal ends of the blades open. When suflicientdistension is accomplished, pressure on the finger piece 41 can stop butthe blades remain latched in their angular position.

For removal of the instrument the distal ends of the blades are closedby digital pressure against the end of tongue 30 to disengage teeth 32from the edge 40. Then the proximal ends of the blades are closed bydigital pressure on the release end 25' of the pawl 25. Pressure by thebody cavity walls returns the blades to their normal or startingposition.

When the instrument is withdrawn the physician can remove his lightsource handle 50 from the speculum 10 and the three part speculum 11, 12and 13, being inexpensively obtained, can then be thrown away.

It will be seen that, in addition to the low cost of the molded plasticparts, the clear plastic blades provide visibility over a larger area.The curved plastic light bar portion 17 forms a light-conducting meansfor bringing light from a source remote from the patient-contactingportions of the instrument, conducts the light around the curve withoutloss and directs the light rays toward the distal ends of the blades.The slide member 12, being of more flexible plastic material, hasintegral therewith the pawl 25 and the tongue 30, the biased members ofthe two latching means, and also facilitates assembly of the trunnionpins 34 in their journals 24. Also the crosssectional configuration ofthe leg portion 15 provides sufficient flexibility in the area of thedetent holes 55. All of the latch means are, therefore, integrallymolded in the three disposable members and are not additional parts asin the prior art. The adjusting means 25 for the spacing of the proximalends of the blades and the finger piece 41 for adjusting the angularrelation of the blades are close together and within easy reach of athumb or finger of the hand grasping the leg 15 or the light handle 50,as are the end of tongue 30 and finger piece 25 which release the latchmeans.

As will be apparent to those familiar with the art, the invention may beembodied in other specific forms without departing from the spirit oressential characteristics thereof.

We claim:

1. A vaginal speculum comprising: a fixed dilatory blade member formedof a transparent, comparatively inflexible plastic material and having adepending hollow leg portion, a slide member formed of a relatively moreflexible plastic material than the fixed blade member and having aforked end, and a movable dilatory blade member formed of acomparatively inflexible plastic material, the movable blade memberbeing pivotally carried by the forked end of the slide member, the legportion and the slide member having cooperating means for slidablyconnecting the slide member to the leg portion, the movable blade memberhaving a lever portion projecting from adjacent its pivotal connectionwith the slide member, the fixed blade member having a curved light barprojecting from the interior surface thereof, the light bar terminatingat a point spaced approximately two-thirds of the length of the bladefrom its distal end in a light-emitting optical surface disposed atsubstantially right angles to the longitudinal axis of the fixed blademember and having a light-receiving optical surface adapted to receivelight from a source disposed in the hollow leg portion, the slide memberand the leg portion having adjustable connection means including a pawlprojecting from the slide member and ratchet teeth on the leg portionengageable by the pawl for locking the slide member and leg portion inadjusted position, and the slide member and lever portion havingadjustable connection means for locking the blade members in adjustedangular relation, the last-named means including a curvedratchet-toothed tongue projecting from the slide member toward the leverportion, the lever portion including pawl means engageable by theratchet teeth of the tongue, the slide member pawl being biased towardthe leg portion teeth and the tongue being biased toward the leverportion pawl means by the resiliency of the plastic material of whichthe slide member is formed; the slide member, its pawl and its curvedratchet-toothed tongue being biased toward the lever portion pawl meansby the resiliency of the plastic material of which the slide member isformed; the slide member, its pawl and its curved ratchet-toothed tonguebeing formed as a one-piece unit of resilient plastic material.

References Cited UNITED STATES PATENTS 2,235,979 3/1941 Brown 12862,186,143 1/1940 Neugass 128l6 X 3,532,088 10/1970 Fiore 12818 596,39912/1897 Fox 12817 2,756,742 7/1956 Barton 128--1S 2,247,258 6/ 1941Shepard 1286 X 3,373,737 3/1968 Moore et a1. 1289 2,240,402 4/1941Joroslow 12816 X 1,246,338 11/1917 Smit 12816 FOREIGN PATENTS 540,80610/1941 Great Britain.

RICHARD A. GAUDET, Primary Examiner G. F. DUNNE, Assistant Examiner

